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More NM DOs

NPTE Neuromuscular

QuestionAnswer
Multiple Sclerosis chronic, progressive, demyelinating disease of CNS
Relapsing Remitting MS relapses and full or moderate recovery, lack of disease progression between relapses
Primary progressive MS Disease progression from onset without plateau or remission or with occasional temporary improvements
Secondary progressive MS initial relapsing-remitting course followed by progression at variable rate
Progressive-relapsing MS Progressive disease from onset but without clear acute relapses, develop disease after 40yr
Sensory problems in MS hyperpathia, paresthesias, dysesthesias, trigeminal neuralgia, Lhermitte’s sign
Hyperpathia hypersensitivity to sensory stimuli
Abnormal sensations dysesthesias
Electric shock like sensation throughout body by flexing neck Lhermitte’s sign
Chronic progressive disease of CNS with degeneration of dopaminergic substantia nigra neurons Parkinson’s disease
Parkinson’s etiology deficiency of dopamine within the basal ganglia corpus striatum with degeneration of substantia nigra
Parkinson’s s/s rigidity (lead pipe, cogwheel), bradykinesia (hypokinesia), resting tremor, impaired postural reflexes, hypophonia, bradyphrenia, dysphagia, mask like face, small writing, restlessness, pill rolling, festination
Abnormal involuntary increase in speed of walking festination
NMJ disorder characterized by progressive muscular weakness & fatigue on exertion Myasthenia gravis
Myasthenia gravis etiology autoimmune antibody mediated attack on acetylcholine receptors at NMJ
Generalized myasthenia usually bulbar and proximal limb muscles, progressive course
Myasthenic crisis with respiratory failure, medical emergency
S/S of myasthenia gravis diplopia, ptosis, dysarthria, dysphagia, drooping facial muscles, hoarse voice, fatigability, repeated muscle use results in rapid weakness, EMG conclusive
Tonic activity stiffening and rigidity of muscles
Clonic activity rhythmic jerking of extremities
Tonic-Clonic Seizure Grand mal, dramatic LOC
Absence seizures petit mal, brief LOC, no convulsions, may occur very frequently
Focal motor seizure clonic activity involving a specific area of body
Focal motor with march (Jacksonian) orderly spread or march of clonic mvmts
Temporal lobe seizures episodic changes in behavior, hallucinations, automatisms, althered cognitive fxn, emotional fxn, aura
Status epilepticus prolonged or a series of seizures >30min, life threatening
Cerebellar lesions tend to produce signs on which side Ipsilateral
Archicerebellum s/s central vestibular (ocular dysmetria, eye pursuit, VOR, eye-hand coord), gait/trunk ataxia with poor postural control, wide based gait. Little change in tone or dyssynergia of extremities
Paleocerebellum s/s Hypotonia, truncal ataxia (disequilibrium, static postural tremor, sway, wide BOS, high guard), posture worse in Romberg. Ataxic gait with unsteady, falls, decr step length, incr step width
Neocerebellum s/s Ataxic limb mvmts, intention tremors, dysdiadochokinesia, dysmetria, dyssynergia
Dyssynergia abnormal timing, movement decomposition of agonist & antagonist interactions, impairments of complex motor tasks
Asthenia generalized weakness
PT goals for Cerebellar Dos eye-head coord ex, stability ex, approxim, wtd belts, dynamic stab w/ sm range control, smooth reversals of mvmt, graded resist, balance trng, pool-graded resist to decr ataxia & postural instab, low stimulus envi, distributed practice for low endurance
Created by: Jenwithonen on 2009-08-12



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